Jewish law prohibits us from causing physical injury (havalah) to ourselves without sufficient justification.
The debate over cosmetic surgery within the tradition accordingly centers upon the precise definitions we give to this prohibition.

Some assert that, so long as a particular cosmetic procedure is not unusually risky and is being contemplated for honorable reasons, the surgery does not violate the guidelines set forth by our sources and sages.

Others, however, argue that cosmetic surgery, like all other medical treatment, is permissible only for r'fu'ah, for healing, for legitimate medical purposes. The desire to improve one's physical appearance is, in and of itself, not such a "legitimate medical purpose." Indeed, it may be viewed as an act of arrogance, a desecration of the human form, and an example of misplaced values: with all the important work that we need to do in the field of medicine and healing, is the enhancement of physical beauty a proper end to which we ought to apply our knowledge and resources?

Reform responsa view the latter position as the better interpretation of Jewish teaching. Our reverence for the sanctity of the human body prohibits us from the capricious manipulation of its form, and surgery intended merely to improve one's physical appearance should be discouraged.

Not All Plastic Surgery is Merely Cosmetic

There are, of course, exceptions to this general rule. We believe that reconstructive surgery, the restoration of one's appearance to an approximation of its former state, is a proper medical objective and not merely cosmetic. Surgery to correct what are generally regarded as regarded as physical deformities is also permissible.

Moreover, for some persons "mere" cosmetic surgery may serve a useful medical purpose in enhancing a sense of psychological and emotional well-being. This is a determination which must be made in each individual case, although we think the argument is too frequently raised and too easily exaggerated. As we understand it, Judaism admonishes us to place less emphasis than we are prone to do on material values and to concentrate upon the development of deeper and more lasting measurements of self-worth and satisfaction. We ought to resist undertaking surgery intended solely for the improvement of physical appearance.

Rabbi Mark Washofsky, Ph.D., is associate professor of rabbinics at Hebrew Union College-Jewish Institute of Religion in Cincinnati, Ohio, and serves as chair of the Responsa Committee of the Central Conference of American Rabbis.